This invention relates generally to tools and methods for surgical procedures. More specifically, this invention pertains to tools and methods useful in conjunction with laparoscopic surgery procedures.
In laparoscopic surgery, a trocar, or more typically, a series of trocars is mounted through the wall of the body cavity in which surgery is to be performed. These trocars provide spaced ports into the cavity for insertion and manipulation of special narrow surgical instruments. Insufflation of the body cavity may be carded out and maintained by seals on the trocar port which permit tool manipulation without excessive loss of insufflation gas. A video camera is generally operated through a trocar port for visualization and control of the procedures in the cavity.
When compared to traditional laparotomy, the use of laparoscopic techniques results in reduced trauma, shortened hospital stay, decreased pain, and reduced cosmetic disfigurement.
The trocars may be sized to provide ports of differing sizes, typically of about 5 mm to 11 mm diameter. The largest trocar port diameter is on the order of about 11 min. The actual incision diameter to provide a given sized port may be slightly smaller than the port, the surrounding flesh stretching somewhat to accommodate the slightly larger trocar port.
Surgical tools used in laparoscopic procedures must have cross-sections which will pass through these small diameter ports. Currently, such tools as retractors, forceps, graspers, suture needles, scissors, knives, laser incision instruments, specimen bags, etc. are available. Each of these laparoscopic tools requires a lengthy rigid handle portion which extends through the laparoscopic trocar port for external manipulation by the surgeon. The long span between the manipulated organ and an available trocar port often makes the desired objective difficult to achieve. While it may be theoretically advantageous to have a sufficient number of trocar ports so that long reaches are unnecessary, such a large number is generally impractical.
Because accessibility to the body cavity is limited by the numbers, placement and sizes of the trocars used, multiple surgical instruments must often be internally extended from remote trocar ports to the target area. Such manipulation over considerable distances complicates the surgical procedures, makes precise manipulation difficult, and crowds the surgical target area. In addition, the presence of intermediate body organs and vessels restricts the accessibility and use of prior art rigid laparoscopic tools at target areas distant from the trocar port.
While laparoscopic techniques significantly reduce the trauma associated with surgical operations, the number of laparoscopic ports in an operation is trauma-limited, nevertheless. In some situations, surgery requiring more than about 5 or 7 laparoscopic ports may be better performed by traditional laparotomic procedures.
The need exists for revised techniques and tools for reducing surgery-induced trauma in laparoscopic surgery.